| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2114 |
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment |
184 |
184 |
$46K |
| L2112 |
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment |
86 |
86 |
$17K |
| L0648 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
25 |
25 |
$11K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
284 |
277 |
$7K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
61 |
61 |
$6K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
46 |
46 |
$2K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
25 |
25 |
$849.76 |
| L3260 |
Surgical boot/shoe, each |
73 |
73 |
$465.12 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
18 |
18 |
$376.72 |